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Discordant growth in twins
Author(s) -
Kingdom John C. P.,
Nevo Ori,
Murphy Kellie E.
Publication year - 2005
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1262
Subject(s) - medicine , umbilical artery , gestation , obstetrics , intrauterine growth restriction , etiology , fetal growth , fetus , single umbilical artery , neonatology , ultrasound , pregnancy , pediatrics , radiology , biology , genetics
Discordant growth in twins contributes significantly to rates of perinatal morbidity and mortality. These rates vary according to chorionicity, timing of onset and severity. We have reviewed English language literature in Medline since 1980. It is clear that diagnosis of discordant growth has improved due to the use of serial ultrasound examination. Following the detection of differences in fetal size, diagnosis is facilitated by umbilical artery and fetal Doppler studies. Management options vary according to chorionicity, timing of onset and umbilical‐fetal Doppler studies. The mode of delivery in discordant twins remains controversial. We conclude that ultrasound surveillance of twin gestations, combining serial biometry and selective Doppler studies, is effective in the recognition of siginificant intrauterine growth restriction in co‐twins. Differences in etiology and management underscore the imortance of establishing chorionicity routinely as soon as twin gestation is diagnosed. Copyright © 2005 John Wiley & Sons, Ltd.